Diabetes

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Introduction

Diabetes has two major forms: Type 1 Diabetes is an auto-immune disorder where insulin-producing β-cells in the pancreatic Islets of Langerhans are attacked by the body's immune system resulting in reduced insulin production. Type 2 Diabetes results from increased tolerance of cells to insulin resulting in a reduced effect of insulin.

Either type of Diabetes is a metabolic disorder where blood-glucose/energy levels are poorly maintained. As the endocannabinoid system is involved in maintaining energy homeostasis/balance, it has great potential in the prevention and/or treatment of Diabetes type 2. Several components of the endocannabinoid system, such as Anandamide and CB1, CB2 and GPR55 receptors, are already implicated in (the treatment of) Diabetes and more are likely to follow.

Similarly, plant cannabinoidsTHC and CBD have reported potential in the treatment of Diabetes and more (such as THCV) are likely to follow. Apart from regulating blood-glucose levels, the endocannabinoid system is also involved in regulating the immune system, more particularly in suppressing auto-immune responses. Therefore, in theory cannabinoids have excellent potential not just to prevent, but also to slow down or even cure both type 1 and type 2 Diabetes. More research is required to discover the true potential of cannabinoids in the treatment of Diabetes.

Please note that, while based on preclinical and/or clinical research, this prescription advice is solely intended as a guideline to help physicians determine the right prescription. We intend to continuously update our prescription advice based on patient and/or expert feedback. If you have information that this prescription advice is inaccurate, incomplete or outdated please contact ushere.

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Literature Discussion

DAGL inhibitors have been proposed to treat metabolic disorders due to their effects on the CB1 receptor through 2-AG (Janssen & van der Stelt, 2016).

So far, Anandamide and CB1, CB2 and GPR55 receptors are implicated in the pathophysiology of Diabetes type 2 (Jenkin et al., 2014; Jourdan et al., 2014; Troy-Fioramonti et al., 2014). This suggests the endocannabinoid system is a valid target for the treatment of Diabetes type 2.

In line with this, CBD and THC were found to help maintain healthy blood-glucose levels and counteract diabetic oxidative stress (Coskun and Bolkent, 2014; Wheal et al., 2014) In mice, CBD was found to prevent β-cell degeneration and insulitis and thus to reduce the incidence and slow-down the development of type 1 Diabetes (Weiss et al., 2006, 2008). Similar results were obtained with THC (Li et al., 2001).

Several clinical trials have shown the potentially therapeutic effects of cannabinoids in the treatment of Diabetes. Not only do cannabinoids promote weight loss, but they also help maintain healthy blood-glucose levels (Hollander, 2007; Hollander et al., 2010; Scheen et al., 2006). However, these trials used the synthetic Cannabinoid Rimonabant, which is much more potent than natural cannabinoids and consequently produces many adverse effects (nausea, dizzyness, depression).

In one 16-patient trial, inhaled THC lowered the pain associated with diabetic peripheral neuropathy. Low (1%), medium (4%) and high (7%) doses all reduced perceived pain and while higher doses were more effective, they also reduced cognitive testing scores as THC does impair short-term memory (Wallace et al., 2015).

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